(Dis)respect and black mortality.
OBJECTIVE
A growing number of studies have documented the deleterious health consequences of the experience of racial discrimination in African Americans. The present study examined the association of racial prejudice--measured at a collective level--to black and white mortality across the United States.


METHODS
Cross-sectional ecologic study, based on data from 39 states. Collective disrespect was measured by weighted responses to a question on a national survey, which asked: "On the average blacks have worse jobs, income, and housing than white people. Do you think the differences are: (A) Mainly due to discrimination? (yes/no); (b) Because most blacks have less in-born ability to learn? (yes/no); (c) Because most blacks don't have the chance for education that it takes to rise out of poverty? (yes/no); and (d) Because most blacks just don't have the motivation or will power to pull themselves up out of poverty? (yes/no)." For each state, we calculated the percentage of respondents who answered in the affirmative to the above statements. Age-standardized total and cause-specific mortality rates in 1990 were obtained for each state.


RESULTS
Both measures of collective disrespect were strongly correlated with black mortality (r = 0.53 to 0.56), as well as with white mortality (r = 0.48 to 0.54). A 1 percent increase in the prevalence of those who believed that blacks lacked innate ability was associated with an increase in age-adjusted black mortality rate of 359.8 per 100,000 (95% confidence interval: 187.5 to 532.1 deaths per 100,000).


CONCLUSIONS
These data suggest that racism, measured as an ecologic characteristic, is associated with higher mortality in both blacks and whites.
Kennedy
B P
BP
Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115, USA. kennedy@hsph.harvard.edu
Kawachi
I
I
Lochner
K
K
Jones
C
C
Prothrow-Stith
D
D
D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D000368:Aged; D015982:Bias; D002423:Cause of Death; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011203:Poverty; D011287:Prejudice; D012044:Regression Analysis; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*